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Young children with protein-energy malnutrition exhibit increased mortality and morbidity, due largely to infectious disease. Recent work has demonstrated that undernourished individuals have impaired immune responses. The most consistent abnormalities are seen in cell-mediated immunity, complement system, phagocytes, mucosal secretory antibody response, and antibody affinity.

These changes, together with other handicapping factors observed in underprivileged societies, lead to more infections, which in turn produce physiological changes that worsen nutritional status. It is now established that deficiencies of single nutrients also impair immune responses. The best studied are zinc, iron, vitamin B6, vitamin A, copper, and selenium. If malnutrition occurs during fetal life, as epitomized by small-for-gestational age infants, the effects on cell-mediated immunity are very significant and long lasting.

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There is much recent evidence to suggest that at the other end of the age spectrum, namely in old age, nutrition plays an important role in maintenance of optimum immunity. These interactions of nutrition and immunity have several practical applications. In this interpretative review, a summary of current findings is given. Unable to display preview. Download preview PDF. Skip to main content. Advertisement Hide. This process is experimental and the keywords may be updated as the learning algorithm improves. This is a preview of subscription content, log in to check access.

Beisel, W.

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Clin Nutr. Google Scholar. Bendich, A. Recently, it has been shown that gut microbial production of trimethylamine N-oxide TMAO from dietary choline and l -carnitine increases the risk of developing cardiovascular disease in both mice and humans, independently of traditional cardiometabolic risk factors Elevated level of TMAO induces vascular inflammation and a direct prothrombotic effect by increasing platelet hyper-responsiveness to multiple agonists in both rodents and humans, and might be involved in the pathogenesis of obesity and type 2 diabetes 90 , It has been shown that high dietary fiber intake promotes modifications of the gut microbiota in both rodents and humans, with decreased Firmicutes and increased Bacteroidetes in particular Bacteroides acidifaciens , which produces high levels of short-chain fatty acids, including acetate, propionate, or butyrate.

Accumulating experimental animal data indicate that gut microbial production of these short-chain fatty acids from dietary fiber can suppress the development of several inflammatory, autoimmune, and allergic disease Some of the beneficial effects of these microbiome-derived metabolites are thought to be mediated by the binding to specific G-protein—coupled receptors expressed on enteroendocrine and immune cells Consistently, in a recent randomized clinical trial, obese individuals randomized to a Mediterranean diet for 2 years experienced a reshaping of the gut microbiota, with an increase in Bacteroides, Prevotella, and Faecalibacterium genera, and most importantly of the Roseburia and Ruminococcus genera and Parabacteroides distasonis and Faecalibacterium prausnitzii bacterial species, which are known for their saccharolytic activity and the capacity to metabolize carbohydrates to short-chain fatty acids Recently, it has been shown that Bacteroides fragilis and F.

In another study, a high adherence to the Mediterranean dietary pattern characterized by a high intake of vegetables, legumes, and fruit was associates with an enrichment of Firmicutes and Bacteroidetes and a rise in fecal short-chain fatty acid levels. In contrast, a poor adherence to the Mediterranean diet was associated with increased l - Ruminococcus and Streptococcus bacteria, and higher urinary TMAO concentration It is likely that a long-term adherence to a certain dietary pattern e.

Indeed, long-term consumption of plant-rich diets with restricted caloric intake has been associated with richer and more phylogenetic diverse fecal microbiota This is important because accumulating evidence suggest that reprogramming human gut microbial functions through long-term adherence to healthier plant-rich diets may influence the physiologic response to specific nutrients, to calorie restriction and to other features of host biology that are instrumental in promoting health and longevity 97 , Accumulating data strongly indicate that nutrition is a key factor for the promotion of health and the prevention of the most common age-associated chronic diseases.


Both the quantity and quality of what we eat is essential to promote metabolic and molecular health 6. Calorie restriction extends health span and life span only when coupled with adequate intake of all the essential nutrients and micronutrients 5.

The traditional Mediterranean diet, unlike the typical North European and American diet, incorporates a wide range of minimally processed fiber-rich plant foods, packed with vitamins, minerals, and phytochemicals. The low consumption of fish, meat, eggs, and cheese provides other essential nutrients, such as vitamin B12, which are lacking in an exclusive plant-based diet.

In the past, the surplus of energy required to perform the high levels of physical labor approximately 70—80 h of work per week was provided by the consumption of energy-dense food, such as extra-virgin olive oil, wine, and dried fruits. Recent findings from animal and human translational studies are starting to shed light on the biological mechanisms that are mediating the beneficial effects of the traditional Mediterranean diet and other healthy dietary patterns such as the traditional Okinawan diet 6.

The moderate energy restriction provided by the high consumption of fiber-rich energy-poor plant foods, the specific restriction of sulfur and branch-chain amino acids and saturated fatty acids, seems to play prominent roles in mediating the health and prolongevity effects of these traditional diets. The gut microbiome processing of a multitude of plant foods packed with fiber, a wide range of vitamins and phytochemicals, can also play a key role in promoting metabolic and molecular health.

However, more mechanistic studies are needed to understand the interactions among calorie intake, single-nutrient modifications, the microbiome, and physical exercise in modulating the key molecular pathways that promote cellular, tissue, and organ health during aging.


Staff Profile - Institute for Ageing - Newcastle University

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Epidemiological Evidence. Findings From Randomized Clinical Trials. Lipid-Lowering Effect. Conflict of Interest. Editor's Choice. Louis, Missouri. Oxford Academic. Google Scholar.

Beatrice Bertozzi, PhD. Louis, MO E-mail: lfontana wustl. Cite Citation. Permissions Icon Permissions. Abstract Consuming a Mediterranean diet rich in minimally processed plant foods has been associated with a reduced risk of developing multiple chronic diseases and increased life expectancy. Mediterranean diet , Cardiovascular disease , Cancer. Table 1. Wine consumed in low to moderate amounts only with meals. Open in new tab.

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  • Open in new tab Download slide. Search ADS. Studies on serum cholesterol and other characteristics of clinically healthy men in Naples. Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study. Beyond calories: an integrated approach to promote health, longevity, and well-being. Promoting health and longevity through diet: from model organisms to humans.

    Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease. A Mediterranean diet and risk of myocardial infarction, heart failure and stroke: a population-based cohort study.

    Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus. La Vecchia. Adherence to the Mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study.

    Mediterranean diet, lifestyle factors, and year mortality in elderly European men and women: the HALE project. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients Indo-Mediterranean Diet Heart Study : a randomised single-blind trial.

    An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. A century of cholesterol and coronaries: from plaques to genes to statins. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study.

    The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. A PCSK9 missense variant associated with a reduced risk of early-onset myocardial infarction. Myocardial Infarction Genetics Consortium Investigators. Inactivating mutations in NPC1L1 and protection from coronary heart disease. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. Nuts and their bioactive constituents: effects on serum lipids and other factors that affect disease risk.

    Effect of a dietary portfolio of cholesterol-lowering foods given at 2 levels of intensity of dietary advice on serum lipids in hyperlipidemia: a randomized controlled trial. Effect of two doses of a mixture of soluble fibres on body weight and metabolic variables in overweight or obese patients: a randomised trial.

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    Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. In equal amounts, the major ruminant trans fatty acid is as bad for LDL cholesterol as industrially produced trans fatty acids, but the latter are easier to remove from foods. Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events in apparently healthy, middle-aged men from the general population.

    Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial. Dietary factors and low-grade inflammation in relation to overweight and obesity. Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions. Jun 8. Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction.

    GPR is an omega-3 fatty acid receptor mediating potent anti-inflammatory and insulin-sensitizing effects. Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Antioxidant and other biological activities of phenols from olives and olive oil. Preventive potential of wheat bran fractions against experimental colon carcinogenesis: implications for human colon cancer prevention. Cardioprotection and lifespan extension by the natural polyamine spermidine. Reduction in cancer risk by selective and nonselective cyclooxygenase-2 COX-2 inhibitors.

    Nonsteroidal anti-inflammatory drugs can lower amyloidogenic Abeta42 by inhibiting Rho. Optimal body weight for health and longevity: bridging basic, clinical, and population research. The role of the gut microbiota in energy metabolism and metabolic disease. Calorie restriction and cancer prevention: metabolic and molecular mechanisms. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women.

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    Restriction of dietary protein decreases mTORC1 in tumors and somatic tissues of a tumor-bearing mouse xenograft model. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. High-protein intake during weight loss therapy eliminates the weight-loss-induced improvement in insulin action in obese postmenopausal women.

    Decreased consumption of branched-chain amino acids improves metabolic health. Cutting back on the essentials: can manipulating intake of specific amino acids modulate health and lifespan. Branched-chain amino acids in metabolic signalling and insulin resistance. Endogenous hydrogen sulfide production is essential for dietary restriction benefits. Diet drives convergence in gut microbiome functions across mammalian phylogeny and within humans. Dietary metabolites and the gut microbiota: an alternative approach to control inflammatory and autoimmune diseases.

    Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk. The TMAO-producing enzyme flavin-containing monooxygenase 3 regulates obesity and the beiging of white adipose tissue.

    An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. De Filippis. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Prior dietary practices and connections to a human gut microbial metacommunity alter responses to diet interventions.